Medical Dermatology

Keloids

Keloids are scars that overgrow the boundary of an original injury or surgical procedure. However, they may result from acne cysts or even occur spontaneously. They become red, thickened, and irregularly shaped, and often have a smooth, shiny surface. Unlike regular scars that soften with time, keloids can remain thickened for years and are often associated with itching, tenderness, and pain.

Keloids can form anywhere on the body, but the most commonly affected areas are the chest, shoulders and back.

Most keloids are effectively treated with a combination of cortisone and 5- fluorouracil injections along with the Vbeam™ laser. This treatment reduces not only the redness and thickness, but also resolves discomfort associated with the keloid. The treatment is safe and causes only minimal discomfort. More than one treatment is generally required for resolution.

Poison Oak

Keloid Treatment | Poison Oak Treatment Kentfield CA | Bay Area

Poison Oak

Poison oak dermatitis is the most common skin allergy caused by contact with plants in the western United States. Contact with poison oak in those who have become allergic to it results in an intensely itchy, red, bumpy, and often blistery rash which may even cause significant swelling and weeping in affected areas.  Lines or streaks of red bumps or blisters are almost diagnostic of plant contact dermatitis. Serious symptoms may include swelling of the face, mouth, neck, genitals, or eyelids and widespread, large blisters that ooze large amounts of fluid.

The rash is caused by urushiol, an allergen found in all parts of the poison oak plant.  People generally don’t react upon initial exposure; therefore, young children rarely get poison oak dermatitis.  But the plant is such a strong allergen that just about everyone with an intact immune system will become sensitized with sufficient or repeated exposure.

The rash typically develops between 8 and 48 hours after contact with the plant, however, it can  appear up to 15 days later.  The time between exposure and development of a rash is determined by the amount of allergen coming in contact with the skin, the thickness of the exposed skin and the  sensitivity of the individual.  Exposure to large amounts of urushiol generally equates with more severe reactions.  A severe reaction to a small amount of urushiol can develop in people who are highly sensitive. The more allergic one is, the less allergen it will take to develop a rash and it will develop sooner.  The rash will continue to develop in new areas over several days, but only on parts of the skin that have touched the plant directly or where urushiol was spread from one area to another.

Once you have changed out of exposed clothing and bathed, you cannot spread the rash on yourself or give it to someone else. The rash may seem to be spreading, but it is usually still developing from previous plant contact or you have touched something that still has the allergen on it. In severe cases of poison oak dermatitis, the rash may seem to be spreading all over the body.  This is an “id reaction” and is mediated by the immune system; i.e., other areas are breaking out in sympathy with the main severe areas of the rash. Direct contact with the blister fluid or the rash will not cause you or someone else to break out. The rash is a manifestation of your allergy; it is not contagious.

Most poison oak rashes can be treated at home.  Mild cases can be treated with wet compresses, cool baths, and calamine lotion. Antihistamines are of no value.  It is important to wash the area immediately after contact with the plant as this will inactivate the allergen.

Moderate to severe cases require treatment by a physician. Often, the early symptoms of itching can be reversed with strong prescription topical steroids. Cortisone pills and injections of cortisone are used in more severe cases.

Without treatment, the rash often lasts up to 3 weeks.  However, in people who are very sensitive to urushiol, the rash can take up to 6 weeks to clear.

The best way to prevent the rash is avoidance. Poison oak has leaves that are shaped somewhat like oak leaves.  The undersides of the leaves area much lighter green than the surface and are covered with hair. It grows as a large standing shrub or vine and there are groups of three leaves in close proximity to each other.
Keloid Treatment | Poison Oak Treatment Kentfield CA | Bay Area

When contact with the plant is unavoidable, protective clothing, such as long pants, a long-sleeved shirt or jacket, and vinyl gloves along with a barrier cream or lotion helps to protect the skin.

Indirect contact with urushiol may also cause the rash, i.e. touching clothing, pet fur, sports equipment, gardening tools, or other objects that have had contact with the plant.

People sensitive to poison oak will also react to poison sumac and poison ivy, which are found in the midwestern and eastern United States.

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